Endoscope &amp; tools for applying sealants and adhesives and intestinal lining for reducing food absorption

ABSTRACT

A first part of the inventive instrument comprises an insertion and removal device in the form of an endoscope which may be inserted through the mouth, pharynx, esophagus and stomach into the small intestine. The inside lumen of the endoscope contains two extendable tools. One extendable tool has a balloon on its end, which may be inflated and deflated. The other extendable tool contains optical fibers for photopolymerizing adhesives and sealants. The second part of the inventive instrument comprises a tubular lining for implantation in and lining of the small intestine, to prevent food from being absorbed into the villi. The lining is anchored in position by means of medical-grade adhesives that are contained on or applied to a mesh sleeve on one end of the lining. The adhesive-coated sleeve is then expanded and glued to the intestine. In operation the lining expands outwardly as digesting food chemicals enter the lining. This allows the normal bodily peristalsis to squeeze the food chemicals through the lining. An alternate tool for an endoscope may be used to apply a coating of biodegradable sealant to the walls of the small intestine to restrict food absorption. Implanting the lining into the intestine or coating the intestine with sealant can be accomplished with no or minimal surgery.

This is a Continuation of my pending U.S. patent application Ser. No.10/1125,771, filed Apr. 3, 2202, entitled: Endoscope & Tools forApplying Sealants and Adhesives and Intestinal Lining for Reducing FoodAbsorption.

This invention relates to medical appliances and more particularly tomembranes and coatings to prevent digesting food chemicals from beingabsorbed through the intestinal vill in order to restrict foodabsorption.

Reduction of food absorption for weight loss may be accomplished inseveral ways. One way is by implanting a membrane-type lining to coverthe intestinal villi and, thereby, reduce the amount of food chemicalsabsorbed. The lining is anchored in position by means of medical-gradeadhesives that are contained on or applied to a mesh sleeve attached toone end of the lining. When the partially digested food chemicals enterthe implant, they are squeezed through the lining by the normalperistaltic movements and contractions, in the patient's body. Thelining retains a collapsed state when empty of food and expandsoutwardly as food chemicals enter. Thus, when the intestinal walls feela change in diameter, they commence peristaltic movements andcontractions, which squeeze the liquefied chyme through the lining andthen out its open end.

The lining can be inserted and removed, without major surgery, by anendoscope, which contains two extendable tools running coaxially withinits lumen. One extendable tool has a balloon on its end that may beinflated and deflated. The other extendable tool contains optical fibersto photopolymerize adhesives and sealants once application is complete.

An alternate endoscopic tool may be used to apply a biodegradablemedical-grade sealant to coat and block the intestinal villi in order toreduce food chemical absorption.

Implanting the intestinal lining or coating the small intestine can beaccomplished with minimal or no surgery.

Obesity has become a problem of epidemic proportion in this country. Agrowing number of people are submitting to surgical treatments whereinportions of the intestine are either cut out, bypassed or stapled inorder to reduce the number of villi in the intestine or interfere withfood chemical absorption. Nowadays, the stomach is frequently stapled toreduce the amount of food it will hold. If a person eats too much, theperson vomits the excess food from the stomach. The more dangerousoperations involving cutting or bypassing the intestine very risky andpeople have even died on occasion.

Thus, there is a need for a less drastic method of reducing caloricabsorption, without resorting to major surgery.

My two previous U.S. Pat. No. 4,134,405 and U.S. Pat. No. 4,315,509 werethe original prior art in the field of linings, which restrict foodabsorption in the intestine. This Continuation contains furtherimprovements and novel alternatives in the field of linings and coatingsfor the alimentary canal.

Accordingly, an object of this invention is to line a large portion ofthe intestine with a tubular membrane in order to restrict foodabsorption through the intestinal villi.

Another object is to coat and block a large portion of the intestinalvilli with a medical-grade sealant for the treatment of obesity.

Still another object of the invention is to cover an ulcerated portionof the intestine so that it may have time to heal without being exposedto the digestive process, especially the stomach's hydrochloric acid.

A further object is to accomplish these and other objects withoutpermanently altering the alimentary canal.

Yet another object is to accomplish these objects in a manner that maybe reversed if unwanted side effects should interfere with normal bodyprocesses.

In keeping with an aspect of the invention, these and other objects areaccomplished by use of a two-part instrument. The first part of theinstrument is an insertion and removal device in the form of anendoscope that may be inserted through the mouth, pharynx, esophagus,and into the stomach or small intestine. The inside of the endoscopecontains two extendable tools that run coaxially through its lumen. Oneextendable tool is equipped with an expandable balloon on its end. Theother extendable tool is equipped with optical fibers to photopolymerizeadhesives and sealants.

The second part of the instrument is a membrane-type lining for theintestine. Attached to one end of the lining is a mesh sleeve, which isglued to the walls of the alimentary canal to anchor the lining inposition.

Normally, for weight reduction most or all of the lining will becontained in the small intestine. However, the two-part inventiveinstrument may be utilized anywhere in the alimentary canal it isdesired to control, restrict or block absorption.

To insert the lining, the mesh sleeve is coated with primer andadhesives and encased in a gelatin capsule secured over the deflatedballoon on the end of the extendable, endoscopic tool. Once the liningand mesh sleeve are correctly positioned, the balloon is inflated,thereby, breaking the gelatin capsule and bonding the mesh sleeve to theintestinal walls.

Thereafter, pulsed ultraviolet light is applied to photopolymerize theadhesive and securely bond it to the intestinal walls. Additionaladhesive and light may be applied to the mesh sleeve, if necessary, byan alternate endoscopic tool. After the mesh sleeve is securely glued tothe intestinal mucosa, the endoscope is removed from the body leavingthe lining anchored in the small intestine.

The lining has a semi-flexible strip, running the length of the lining,which stabilizes the lining and prevents it from twisting shut orkinking.

An alternate endoscopic tool applies a biodegradable sealant to thewalls of the small intestine to coat and, thereby, block food absorptionthrough the intestinal villi.

For this procedure, the small intestine is expanded and held open by aTeflon-coated frame, which is extended beyond the endoscope. TheTeflon-coated frame is compressed when it is inside the endoscope. Theframe expands outwardly, of its own resilience, once it is no longerrestricted within the endoscope. A medical-grade sealant is then appliedto the intestinal walls through the frame. Thereafter, a pulsedultraviolet light is applied, with the frame still expanding theintestine, to photopolymerize the sealant onto the intestinal walls.

The sealant is biodegradable so it is slowly absorbed by the body.

All tools and instruments contained within the endoscope, which comeinto contact with the adhesives and sealants, must be coated withTeflon, silicone or other non-stick material so bonding will not occur.

The nature of the preferred embodiments may be understood best from astudy of the attached drawings, wherein:

FIG. 1 is a schematic diagram showing the inventive lining beingimplanted in the small intestine, and the endoscope in a position whereit is about to be used to glue the mesh sleeve in position;

FIG. 2 schematically shows, somewhat in perspective, a tubular lining,which may be implanted in the small intestine;

FIG. 3A is a perspective view of the three main parts of the endoscope,which is used as a tool for implanting and removing the lining of FIG.2;

FIG. 3B is a perspective view of an alternate balloon catheter to aid inimplanting a hydrogel lining;

FIG. 4 is a perspective view of the main parts of an alternateendoscope, which shows a frame being extended to expand the intestineand an endoscopic tool for applying and photopolymerizing adhesives andsealants;

FIG. 5 is a cross section taken along line IA-IA of FIG. 4 showing theTeflon-coated frame dilating the intestine;

FIG. 6 is a cross section taken along line IB-IB of FIG. 4 showingoptical fibers directed outward to photopolymerize the sealant and bondit to the intestinal walls;

FIG. 7 shows a heat coil which may be used to bond adhesives andsealants;

FIG. 8 is a perspective view of an alternate endoscope, which contains abrush that can be rotated, to apply and mix two-component adhesives andsealants; and

FIG. 9 is a perspective view of alternate frame means and alternate tubemeans for applying primer & sealant.

In the description that follows, any suitable medical grade material maybe used for the lining, mesh sleeve, endoscope and endoscopic tools.

One embodiment for the lining is preferably, manufactured of siliconerubber. The other embodiment for the lining is preferably made ofhydrogel which is slowly absorbed by the body.

The mesh sleeve may be manufactured of any material, which themedical-grade adhesives will securely bond with. Preferably, theseinclude hydrogels, marine adhesive proteins, polymeric sealants, fibringlues, cyanoacrylates, laser solder adhesives, elastromers,collagen-thrombin fleece, bone dust sealants, albumin solutions, andtissue adhesives based on protein engineering.

Several of the above are presently being used instead of sutures andstaples for binding of skin and tissues during surgery. The newadhesives and sealants can be engineered to be absorbed, by the body,over a predetermined amount of time. At present, it is thought that ahydrogel should be used such as “FocalSeal”. “FocalSeal” is a registeredtrademark for Focal, In and Genzyme Surgical Products' hydrogelmaterials and related products. Ethicon, Inc. A Johnson & JohnsonCompany is marketing the product.

According to the product overview Focal is currently developing twoprinciple FocalSeal Surgical Sealant products for a broadrange ofapplications inside the body.

The company's FocalSeal-L Sealant and FocalSeal-S Sealant are designedto have absorption times that parallel long-term and short-termsynthetic, absorbable polymer sutures. Focal believes that these twosealants will be widely applicable to lung surgery, cardiovascularsurgery, neurosurgery, gastrointestinal surgery and other surgicalapplications.

The company's sealants adhere to tissue as a result of a proprietary2-step priming and sealing process. The physician first applies a liquidprimer that penetrates into the crevices of the tissue, and then thesealant is applied. Both are exposed to a standard wavelength of visiblelight and in 40 seconds polymerize, or change from a liquid to a solidgel (a process known as photopolymerization). The solid gel formed afterthe light has been applied is highly flexible, elastic and transparent,and strongly adheres to moist or dry tissue. Focal's products remainadherent during the critical wound healing process, and are thenabsorbed and eliminated from the body. Regardless of whether “FocalSeal”material is used or not used, the material should have thesecharacteristics.

Additionally, an adhesive hydrogel tape is currently available.Accordingly, the anchoring sleeve could be engineered entirely fromhydrogel tape, which would eliminate or reduce the need for primer andadhesive.

A different form of glue utilizes a composition of two-componentsolutions, which are mixed together at the point of application. Theysolidify rapidly without a light source. Examples include marineadhesive proteins, collagen-thrombin fleece, fibrin glues, hydrophilicgels, and cyanoacrylates, to name a few.

For tissue welding with adhesives and sealants, the Yag, CO Sub 2, THC:Yag and Argon lasers are all being used with success and the laser lightcould be utilized in the inventive endoscopic tools through the opticalfiber.

Currently different adhesives and sealants are being successfullyutilized during surgery and many more are being experimented with in thefield of protein engineering.

These and other suitable materials, adhesives and sealants are used tomake the inventive two-part instrument. The first part of the instrumentis a maneuverable endoscope 10 (FIG. 1), which is used as an insertionor removal device or tool, which may be inserted through the mouth,pharynx, esophagus, and into the stomach or small intestine. The term“endoscope” has been used throughout this application, however, itshould be understood that any form of maneuverable tube or catheter canbe employed to contain the insertion and removal tools.

In greater detail, endoscope 10 includes an extendable tool 22, whichruns coaxially through the lumen of endoscope 10. The distal portion ofextendable tool 22 contains a balloon 26 formed around its outercircumference. Balloon 26 is made of silicone rubber so the adhesivematerial will not bond to it. Optical fibers 30 are contained withinlight wand 32 in endoscope 10 for photopolymerizing the adhesives.

The lining 40 (FIG. 2) includes a long and extremely thin-walled tube42. Thin-walled tube 42 contains a narrow, stabilizing strip 46.Stabilizing strip 46 is semi-flexible to prevent thin-walled tube 42from twisting shut or kinking as digesting food chemicals are squeezedthrough it.

Incorporated into one end of thin-walled tube 42 is a mesh sleeve 50. Aprimer and adhesive coating 52 is applied to mesh sleeve 50 prior toinsertion into the body.

Alternately, an anchoring sleeve may be engineered entirely of adhesivehydrogel tape eliminating the need for applying primer and adhesivecoating 52.

FIG. 3 A shows the endoscope 10 used to insert and remove lining 40.Endoscope 10 is equipped with a camera 12 for viewing inside the body.Optical chamber 9 connects camera 12 and eyepiece 14. The end portion 16of endoscope 10 is coiled so that it may be maneuvered in a desireddirection by adjusting knob 17. Knob 17 controls the angle and directionof end portion 16 via cables 18, which run through tiny passageways 19within walls 20 of endoscope 10.

The lumen 21 of endoscope 10 contains two extendable tools, which aretelescopically fitted together. Extendable tool 22 slides within lumen21 of endoscope 10 and light wand 32 slides within lumen 25 ofextendable tool 22. Both extendable tool 22 and light wand 32 can beextended beyond the distal end of endoscope 10.

Extendable tool 22 has a balloon 26 incorporated around the outercircumference of its end portion 24. An air passageway 28 runs throughwalls 23 of extendable tool 22. Air passageway 28 is used to inflate anddeflate balloon 26.

Light wand 32 contains optical fibers 30 that are connected to a xenonlight source 36 located in the procedure room. Photopolymerizationoccurs after a forty-second pulsed application of light (480-520 mmwavelength), is applied from the xenon light source 36. Ends 34 ofoptical fibers 30 are directed to point outward to apply the pulsedultraviolet light to the intestinal walls. Since the ultra violet lightis pulsed, the patient is exposed to a minimal amount of ultravioletlight.

For insertion into the body, mesh sleeve 50 is given an application ofprimer and adhesive coating 52 and then positioned over the deflatedballoon 26. The coated mesh sleeve 50, positioned over deflated balloon26, is encapsulated within a gelatin capsule and pulled inside lumen 21of endoscope 10.

An alternate method is to manufacture mesh sleeve 50 from adhesivehydrogel tape. For this method, mesh sleeve 50 would be secured overdeflated balloon 26, sticky side out, and encased in a gelatin capsule.Mesh sleeve 50 would then be pulled inside lumen 21 of endoscope 10.

Thin-walled tube 42 retains a compressed state from a series oflengthwise folds 58 so further compression is not necessary. However, agelatin capsule 56 may be placed on the end of thin-walled tube 42 tobetter streamline it into the body.

Once the physician has determined lining 40 has reached the correctlocation for implantation, mesh sleeve 50 is released from inside lumen21. Balloon 26 is then inflated which breaks the gelatin capsule andpresses mesh sleeve 50 against the walls of the intestine, thereby,gluing it in place. The physician then deflates and retracts balloon 26back inside endoscope 10. Light wand 32 is then extended to positionends 34 of optical fibers 30 inside mesh sleeve 50. Optical fibers 30are energized for forty seconds, via xenon light source 36. tophotopolymerize the adhesive and bond mesh sleeve 50 to the intestinalwalls. The light wand 32 is then retracted back inside lumen 25.Endoscope 10 is then removed from the body leaving lining 40 anchored inthe intestine.

To remove the lining from the body, a slender forceps may be placedinside lumen 21 of endoscope 10 to grasp a loop 54 on mesh sleeve 50.The loop 54 and mesh sleeve 50 are then pulled partially insideendoscope 10 for compression prior to removal from the body.

Balloon 26 and optical fibers 30 could be incorporated into oneendoscopic tool instead of two.

FIG. 3B shows an alternate insertion tube 36 containing an elongatedballoon 38, which may be inflated to glue a hydrogel lining 41 to theintestinal mucosa. Preferably, balloon 38 is a foot or more in length toaccommodate hydrogel lining 41 which is a foot or longer in length.

In operation, the hydrogel lining would be secured over the length ofthe deflated elongated balloon 38. A long gelatin capsule could be slidover the hydrogel lining 41 to secure it to insertion tube 36. Oncepositioned in the intestine, elongated balloon 38 would be inflated tobreak the gelatin capsule and bond hydrogel lining 41 to the intestine.Over time, hydrogel lining 41 would be absorbed by the body, so removalof the lining would not be necessary.

Holes 49 may be punched through silicone lining 40 or hydrogel lining 41to allow limited food absorption.

Additionally, silicone lining 40 or hydrogel lining 41 may be implantedthrough an incision in the abdomen for surgeons who prefer a more visualprocedure.

FIG. 4 shows an alternate endoscope 60 which can be used to applyadhesives and sealants to the walls of the alimentary canal oradditional adhesive to mesh sleeve 50.

In greater detail, endoscope 60 contains a frame 62 which can beextended out from lumen 64 of endoscope 60. Frame 62 is coated withTeflon or other non-stick material to prevent bonding with the adhesivesand sealants.

Frame 62 comprises a series of billowed bands 68, which expand outwardlyof their own resilience once frame 62 is extended beyond the confines ofendoscope 60. Sealant tool 70 slides within the center of frame 62through rings 69. Rings 69 reinforce and join billowed bands 68 togetherat constrictions 73.

FIG. 5 is a cross sectional view of frame 62 dilating the intestine.Frame 62 dilates the intestine while a biodegradable sealant is appliedto the intestinal villi. Frame 62 is left in position during thephotopolymerization process as it keeps the wet, sealant-coated,intestinal walls away from the optical fiber chamber.

In operation, roughly a two-foot section of the small intestine will becoated with sealant. In a living person the small intestine isapproximately five feet in length. The twenty-foot quotes oftenattributed to the intestinal length are measured in a dead person whoseintestine has lost its tonus and with the intestine stretched out to themaximum. Applying sealant to a two-foot portion of the small intestinewill result in safe yet reliable weight loss.

In greater detail, sealant-tool 70 (FIG. 4), contains a primer chamber72 in its distal portion 74. Primer chamber 72 is preferably at leastsix inches in length to allow at least six inches of the intestine to beprimed at one time. A passageway 77, for delivering primer, runs throughsealant tool 70. The primer is directed, under pressure, into primerchamber 72 and is sprayed through openings 78.

Directly behind primer chamber 72 is adhesive chamber 80. Adhesivechamber 80 is preferably at least six inches in length to allow at leastsix inches of the intestine to be coated with adhesive at one time. Apassageway 82, for delivering the adhesive, runs through sealant tool70. The adhesive is directed, under pressure, into adhesive chamber 80and is sprayed out openings 84.

Behind adhesive chamber 80 is light chamber 90 containing optical fibers92. Ends 94 of optical fibers 92 are arranged to shine outward so lightis directed at the intestinal mucosa. Ends 94 of optical fibers 92 canbe circularly arranged to photopolymerize at least six inches of theintestine at one time. Optical fibers 92 are attached to a xenon lightsource 96 located in the procedure room.

FIG. 6 is a cross section of light chamber 90 with optical fibers 92directed outward to photopolymerize the sealant and bond it to theintestinal walls.

Light chamber 90 may be separated several inches or more from chambers72 and 80 to prevent any primer/sealant from splattering on lightchamber 90 during the application process.

Alternately sealant tool 70 may be designed with primer chamber 72 andadhesive chamber 80 constructed around an open lumen. Containing lightwand 32 within a lumen running through sealant tool 70 would protect thelight chamber even further during the application process, if necessaryor desired.

In operation, endoscope 60 is inserted through the mouth, pharynx,esophagus, and stomach into the small intestine. Once endoscope 60 is inthe desired location, frame 62 is extended approximately two feet beyondthe distal end 65 of endoscope 60. Billowed bands 68 in frame 62 expandoutwardly which dilates a two-foot portion of the small intestine.

The physician extends sealant tool 70 six inches beyond distal end 65 ofendoscope 60. The physician then energizes an outside pump which forcesthe primer into chamber 72 causing it to be expelled through openings78. The doctor coats this section of the intestine with the desiredamount of primer.

The physician then advances sealant tool 70 another six inches toposition adhesive chamber 80 in the area just coated with primer. Thephysician energizes an outside pump, which forces the adhesive intoadhesive chamber 80 and out openings 84. The doctor applies the adhesiveon top of the primer to thoroughly coat it.

At this point the physician can activate the xenon light source 96 andadvance sealant tool 70 to bring light chamber 90 into the area justtreated with primer and adhesive. Light chamber 90 photopolymerizes thesealant in 40 seconds. This turns the sealant into an elastic gel-likesubstance, which bonds to and coats the intestinal walls. Frame 62 holdsthe wet, sealant-coated, intestinal mucosa away from light chamber 90during the photopolymerization process.

The doctor can alternately coat the remaining portion of the expandedintestine with primer, adhesive and light by advancing sealant tube 70.

Sealant tool 70 may be marked in inches 98 to aid the doctor in how farto advance the tube.

Additionally, sealant tool 70 may be exchanged with alternate endoscopictools. For example, sealant tool 70 may be inserted into endoscope 10(FIG. 3), to apply more primer and adhesive to and through mesh sleeve50.

Also, laser light could be brought through optical fibers 92 whensealant bonding using laser light is desired. For this a low-power lasermust be used.

Additionally, brushes may be incorporated onto the exterior surface ofprimer chamber 72 sealant chamber 80 to better “paint” the primer andsealant into the crevices of the intestinal mucosa.

Also, some surgeons may prefer a more visual procedure and for this asmall incision may be made in the abdomen.

FIG. 7 shows a chamber 100, which utilizes temperate heat to bondadhesives and sealants to the intestinal walls. A heat coil 102 isproperly insulated and incorporated into one of the endoscopic tools inlieu of the light chamber.

FIG. 8 shows an applicator 110 for applying adhesives and sealants.Applicator 110 is used in conjunction with two-compound sealants thatmust remain separated until application, because they solidify rapidlyafter contact with each other. Normally, a light source is not necessaryto solidify these two-component sealants.

In greater detail, applicator 110 fits within lumen 112 of endoscope114. The applicator 110 contains a brush portion 116 and a handleportion 118. The brush portion 116 has a series of billows 117 andconstrictions 119 to better coat the uneven intestinal mucosa.

Brush portion 116 is preferably at least six inches in length to coat atleast six inches of the alimentary canal at a time. Applicator 110 iscoated with Teflon, silicone or other suitable non-stick material.

Brush portion 116 contains two bladders 120 and 122, which are of asemi-crushable nature. When brush portion 116 is pulled inside endoscope114, the billows 117 compress. When brush portion 116 is released fromthe confines of endoscope 114, the billows 117 expand of their ownresilience and dilate the intestinal walls. This slight pressure on theintestine produces a tighter bond between the sealant and the intestinalmucosa. The slight pressure, also, allows bristles 134 to better mix andblend the two compound sealant.

Sealant is delivered to bladder 120 through tube 124 and a differentsealant compound is delivered to bladder 122 through tube 126. Amultiplicity of openings 130 are formed through bladder 120. Bladder122, also, contains a multiplicity of openings 132.

Bristles 134 of various lengths are formed over the surface of brushportion 116. Bristles 134 are of a soft nature and of different lengthsto better mix the two-compound sealant into the rough intestinal mucosa.

In operation, a physician extends brush section 116 six inches beyondthe end of endoscope 114. The physician then energizes an outside pump,which forces the two separate sealants, into bladders 120 and 122. Thesealants then flow out openings 130 and 132. At this point the physiciandisconnects the sealant tubes and rotates handle 118 for approximatelyone minute so the bristles 134 mix and blend the two sealants together.Endoscope 114 acts as a sheath and protects the body from irritationwhile applicator 110 is being turned. Within five minutes the combinedsealants form a solidified, gel-type coating over the intestine.

Applicator 110 should not be extended to coat the next section ofintestine until the sealant has had a chance to solidify. Brush section116 being a non-stick material can dilate the intestine, during thepolymerization process, without adhesion occurring.

A Teflon-coated frame can, also, be utilized in conjunction withendoscope 114 to dilate the intestine during the sealant application andpolymerization process.

FIG. 9 shows an alternate stent-like, frame means to dilate theintestinal walls during sealant application. Preferably, stent framemeans 140 is at least one foot in length so at least one foot ofintestine can be primed and coated. Additionally, it is made of anon-stick material. In operation, stent frame means 140 is inserted intothe intestine in a collapsed state. Once at the desired site, it isexpanded by pushing wire 142 that runs the length of stent frame means140. Tool 144 is then inserted into stent frame means 140. Stent framemeans 140 then acts as a sheath for protecting the bodily passagewaywhile tool 144 is maneuvered and turned.

Tool 144 contains a passageway 146 running the entire length of tool 144for delivering primer to the intestinal mucosa through opening 148. Tool144 contains a brush section 150 on the surface of its distal end whichcan be turned and maneuvered to paint the primer onto the intestinalwalls. After the primer application is complete, tool 144 can be removedfrom inside stent frame means 140 and a duplicate tool 144 inserted fordelivering the sealant coating. After the sealant application iscomplete, duplicate tool 144 is removed from inside stent frame means140 and light wand 152 inserted to complete the photopolymerizationprocess.

There are other applications for lining or coating portions of thealimentary canal. For example, duodenal ulcers, which are the mostcommon, are aggravated by the stomach's hydrochloric acid constantlyemptying onto the ulcer, thereby, eroding it further. A lining orcoating over the ulcer would prevent hydrochloric acid from coming intocontact with the ulcer and allow it to heal.

To treat duodenal ulcers, the lining would commence in the stomach andbypass the hydrochloric acid through the lining instead of onto theulcer.

Similarly, acid-reflux disease could be treated by coating the esophagusso gastric juices cannot erode and burn the lower esophagus.

Diverticular disease could, additionally, be treated with the lining.Diverticulosis is the presence of small, sac-like swellings in the wallsof the alimentary canal. When the sacs become infected with stagnantfood, it is a medical emergency usually requiring surgery. The liningcould be glued over each diverticula after the pouch is flushed withwater. The lining would prevent digesting food chemicals from becomingtrapped in the diverticula.

In operation, different components of the endoscopic tools could beinterchanged with each other.

Additionally, the lining and/or endoscope could be inserted through therectum, which would allow a physician to use an endoscope with a widerinside lumen for containing the tools. For this application the variouschambers could be in the reverse order.

Also, the tip of an endoscope, maneuverable catheter or endoscopic toolcould contain an ultrasound transducer to aid in insertion and removalof the lining or aid in coating of the intestine.

Also, a series of tiny mirrors could be utilized with the optical fibersto aid in the photopolymerization process.

Those skilled in the art will readily perceive still other changes andmodifications which may be made in the inventive structures and perceivenew and different uses for the inventive structures. Therefore, theappended claims are to be construed broadly enough to cover allequivalent structures falling within the scope and the spirit of thisinvention.

24. An instrument for use in applying a coating to an interior surfaceof an intestine for restricting food absorption, the instrumentcomprising: a flexible endoscope member having a proximal end, a distalend, wherein the distal end configured to be inserted into theintestine, and a lumen therethrough; a second elongate member to beinserted through the lumen of the flexible endoscopic member, whereinthe second elongate member having a proximal portion, a distal portion,a passageway, and a plurality of flexible bands disposed at least on thedistal portion, said flexible bands configured to expand outwardly tocontact the interior surface of the intestine and radially expand theintestine when the distal portion of the second member is extendedbeyond the distal end of the first member; a coating delivery toolconfigured to be inserted into the passageway of the second member, saidcoating delivery tool having a proximal portion, a distal portionconfigured to extend beyond the distal portion of the flexibleendoscopic member for applying a coating to the interior surface of theintestine, at least one internal passage, and an outer surface, whereina coating is applied to the interior surface of the intestine.
 25. Theinstrument of claim 24, wherein a component of said coating is abiodegradable primer.
 26. The instrument of claim 24, wherein acomponent is a biodegradable adhesive or biodegradable sealant that isconfigured to be slowly disintegrated over time and eliminated by thebody.
 27. The instrument of claim 26, wherein a component is aphotopolymerizing biodegradable sealant or photopolymerizingbiodegradable adhesive.
 28. The instrument of claim 27, wherein thecoating delivery tool further comprises plurality of side openings onthe outer surface wherein the plurality of side openings configured toreceive optical fibers, wherein the optical fibers operate coupled to alaser, configured for curing the coating after the coating is applied tothe interior surface of the intestine.
 29. The instrument of claim 26,wherein the coating delivery tool further comprises a heating coil,wherein the heating coil operates coupled to a heat source, configuredfor curing the coating after the coating is applied to the interiorsurface of the intestine.
 30. The instrument of claim 24, wherein thesecond elongate member further comprises a non-stick coating thatprevents adhesive and sealant bonding to the second member.
 31. Theinstrument of claim 24, wherein the flexible endoscope member furtherincludes an ultrasound transducer, said the ultrasound transducerconfigured to aid a surgeon to accurately positionthe distal end of theendoscopic member inside the intestine.
 32. The instrument of claim 24,wherein the second elongate member further includes markings on theouter surface, said the markings configured to aid a surgeon inaccurately positioning the distal end of the second member inside theintestine.
 33. A method for applying a coating to an interior surface ofan intestine for partially restricting food absorption from the insideof the intestine to the body thereby treating obesity, the methodcomprising: inserting the distal end of the flexible endoscopic memberinto the intestine, inserting the second elongate member into the lumenof the flexible endoscopic member, extending the distal portion of thesecond elongate member beyond the distal end of the endoscopic memberthereby expanding the distal portion of the second elongate memberoutwardly to contact the interior surface of the intestine and radiallyexpand the intestine, inserting the coating delivery tool into thepassageway of the second member and positioning the distal portion ofthe coating delivery tool proximate to the distal portion of the secondmember, applying the first component of an adhesive or sealant to theinterior surface of the intestine, applying the second component of anadhesive or sealant to the interior surface of the intestine, andapplying energy to cure the coating.
 34. A method of claim 33, whereinthe first component is a biodegradable primer.
 35. A method of claim 33wherein the second component is a biodegradable adhesive orbiodegradable sealant that is configured to be slowly disintegrated overtime and eliminated by the body.
 36. A method of claim 33, wherein theenergy being applied is heat.
 37. A method of claim 33, wherein theenergy being applied is laser.
 38. A hydrogel lining for blocking theintestinal villi in order to restrict food absorption, whereby a personmay consume whole food through the mouth, said whole food becomingpartially digested in the stomach before coming into contact with saidhydrogel lining, and means for controlling a transfer of food chemicalsfrom said digesting food solids through the walls of said hydrogellining to the alimentary canal by preventing or altering the transfer ofsaid food chemicals between said hydrogel lining and the walls of thealimentary canal to be used to treat obesity.
 39. The hydrogel lining ofclaim 38 wherein it is pressed into position by a balloon catheter atleast one foot or longer in length.